Earlier this month, the World Health Organisation issued its first global report on diabetes and warned that the number of adults living with the illness had almost quadrupled since 1980 to 422 million adults. In 2012 alone, the report went on to say, diabetes caused 1.5 million deaths. Diabetic complications led to heart attack, stroke, blindness, kidney failure and lower limb amputation. Another WHO report notes that 285 million people are estimated to be visually impaired worldwide, 39 million of them blind and 246 with low vision.
The standard approach to solving these afflictions has been either to design drugs or invoke surgery. And though these are the most practical approaches, they come with their own set of side effects. For instance, the consequence of using metformin — the most common among type 2 diabetes medications — is weight gain, an increased susceptibility to fractures, impedance of normal liver function and fluid retention. As for cataract, surgeries are ubiquitous but there are challenges to performing them in low-income settings.
Imagine for a moment if scientists and researchers could go back to their drawing boards and see these diseases in a new light. What if there was a pill to cure cataract? What if it was possible to identify, at a very early stage, whether an individual was particularly susceptible to diabetes and, therefore, tailor certain lifestyle changes immediately? Even better, what if we could dispense with medicine and scalpels and grow entirely new organs that were better than the ones that we were born with?
Medical science’s pilgrim quest to heal and enhance health has made scientists explore unusual ideas and look for inspiration from fields as diverse as machine learning, weather science, nanotechnology and robotics.
Here are five radical ideas that medical researchers from across the world, including India, are working on today to find out-of-the-box solutions to enduring problems. Can we hope, in our lifetime, to grow a new pair of hands?
3-D printing that heals
Not too long into the future, it may be possible to ‘print out’ living tissue that can be used to make body parts. Researchers at the Wake Forest Institute for Regenerative Medicine, North Carolina, reported in February’s edition of Nature Biotechnology of being able to print cells on to the body to heal wounds. A key challenge in such approaches has been that artificial cells don’t seem to survive long, but the researchers in this case seem to have been able to work around this.
The Integrated Organ and Printing System (ITOP) that they use is a step-up from conventional 3-D printers. It uses a biodegradable material that can take the shape of tissues. It also uses a water-based ink to hold cells and a series of micro-channels to allow oxygen and nutrients to flow through and develop resilient tissue that can safely integrate into animal and human bodies. Among the first successes for ITOP was its ability to print human-sized ears that were implanted under the skin of mice, which in two months formed cartilage and blood vessels. Promising as this appears, it may be a while before it clears various levels of animal and human trials. There is, however, a more immediate application for the same technology. The ITOP can be programmed to mix a variety of medicines into a single pill and then be fashioned into a ‘release system’ that would control the time at which each drug is released. This would mean that every patient — with her or his own unique combination of allergies and sensitivity to certain medicines — could have her or his own customised pill and thereby be free of the irritating (and sometimes toxic) side-effects that come with ingesting certain drugs.
Intelligent prosthetics
Medicine doesn’t advance merely by drug and treatment but also through devices that are increasingly able to integrate extremely efficiently with the brain. This could mean a new class of prosthetics that not only compensate for missing or amputated organs but in some cases even outperform their natural counterparts. The current class of medical prosthetics responds accurately to nerve impulses or muscle movements in the body of the wearer and now research teams are plugging these medical aids into the brain. So-called brain-machine interfaces (BMI) can read the electrical patterns of the brain that can then be decoded by computer algorithms. A team at the University of California, Irvine, has developed a sophisticated BMI that can make electrical pulses from the brain travel down wires attached to the muscles in the legs and substitute for a spinal cord. Though these are still early days, the technology has enabled a man with a spinal cord injury to walk for the first time in seven years. The same essential approach underlies progress in the development of artificial skin. By developing an array of sensors, researchers have been able to make its sensitivity comparable to that of human fingertips.
Separately, a team from Stanford designed a system of carbon nanotubes that can be fitted into the skin and be made sensitive to pressure. This consists of a malleable circuit of pressure sensors layered on an organic substance, which converts the pressure into an electric signal that can stimulate the brain cells of a mouse’s cortex. So far the tests were only on brain cells sourced from mice but had the researchers tested the artificial skin on real rodents instead of just their brain cells, the mice would likely have been able to “feel” the skin as their own.
Chaos theory to catch diabetics young
The gravity of diabetes is a no-brainer. According to the latest warning from the World Health Organisation, nearly 422 million adults worldwide were living with diabetes in 2014 compared with 108 million in 1980. 50 per cent of them were concentrated in just five countries including China, India, Indonesia, Brazil and the U.S.
For some time, experts have known that the underlying cause of type 2 diabetes, the most common form of the condition, is due to the malfunctioning of insulin — a key hormone necessary for regulating glucose in the body. Obesity and a lack of exercise are believed to facilitate diabetes, while on the other hand a significant body of research says that an unchecked intake of carbohydrates — most commonly sugar — from the various processed foods that are a staple of urban diets are more likely to blame.
The only consensus is that diabetes is a syndrome that must be managed and the earlier it is detected, the better the chances of an unimpeded life. “Catching it early, however, is one of the most difficult challenges,” says Kanury Rao of the Translational Health Science and Technology Institute, Haryana. With a database of nearly 2,000 molecular samples from patients, Rao hopes to be able to develop a platform that can detect signatures of the onset of diabetes. If they can trace how a healthy individual moves to a pre-diabetic state and from then on to contracting eye or kidney disease, it could lead to a possible product that can predict the onset of diabetes. “There are other labs in the world with better analytics but nobody has approached the problem in the way we are going at it,” Rao adds. Their approach would be inspired by chaos theory, an idea in physics that suggests that small fluctuations in predictable systems can build up and cause vast changes over time, like they do in weather.
Thus, small chemical signatures at an early age could indicate the onset of potential disease and the group’s analysis will be aimed at catching them young.
Melting cataracts
It’s 2016 and medicine still hasn’t succeeded in curing cataracts, the leading cause of blindness globally. The only solution now is to surgically remove the clouded lens from the eye and replace it with an artificial lens. U.S. scientists now say that they have developed eye drops that claim to be able to “melt” cataracts away. They have discovered a naturally occurring steroid, known as lanosterol, and plan to test it on donated human lenses. According to Medical Daily , not only did lanosterol significantly shrink the size of the cataract, but it also prevented it from returning. Researchers are still trying to understand how lanosterol manages to melt cataracts away, but they suspect that it has got to do with preventing the build-up of protein that prevents light from getting through.
Nanoparticles beat the superbug
A concern that equally hackles doctors and researchers is that of antibiotic-resistant bacteria. These “superbugs”, as they are called, can hobble existing treatments to tuberculosis and infections from E. coli and salmonella. An alarmed World Health Organisation warned in 2014 that the world is heading for a post-antibiotic era, in which even common infections and minor injuries, which have been treatable for decades, can become deadly and kill again.
Hope is at hand as a researcher duo at the University of Boulder, Colorado said in a paper in the journal Nature Materials that the key to fighting the tiny bacteria lay in harnessing the power of something tinier. New, light-activated nano-particles known as “quantum dots” that are 20,000 times smaller than a human hair and resemble the tiny semiconductors used in consumer electronics, successfully killed 92 per cent of drug-resistant bacterial cells in a lab-grown culture. Though it has previously been shown that metal nanoparticles — created from silver and gold, among various other metals — can combat antibiotic-resistant infections, they are likely to potentially damage healthy cells as well. Quantum dots, however, can be tailored to particular infections thanks to their light-activated properties. The dots remain inactive when in darkness, but can be “activated” on command by exposing them to light, allowing researchers to modify the wavelength in order to alter and kill the infected cells, according to a press statement from Colorado University.
